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Allgemein- und Viszeralchirurgie up2date 2017; 11(05): 461-479
DOI: 10.1055/s-0043-113906
Oberer Gastrointestinaltrakt
Georg Thieme Verlag KG Stuttgart · New York

Ösophaguskarzinom Update

Nadja Niclauss
,
Alexandra M. König
,
Jacob Izbicki
,
Stefan Paul Mönig
Further Information

Publication History

Publication Date:
05 October 2017 (online)

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Das Ösophaguskarzinom weist trotz multimodaler Therapieansätze weiterhin nur geringe 5-Jahres-Überlebensraten von 15 – 25% auf. Angelehnt an die im Jahr 2015 publizierte S3-Leitlinie sowie die „ESMO Clinical Practice Guidelines“ stellen wir in diesem Artikel Diagnostik, Staging und Therapie der Plattenepithelkarzinome und Adenokarzinome des Ösophagus dar.
Kernaussagen

  • Die Diagnostik erfolgt durch Ösophagogastroduodenoskopie mit Biopsien.

  • Für das Staging sind Endosonografie und Computertomografie notwendig.

  • Bei Frühkarzinomen (T1a; ggf. T1b bei Adenokarzinomen) kann eine endoskopische Resektion versucht werden.

  • Bei lokal fortgeschrittenen Karzinomen (T3–4 oder N+) ist eine multimodale Therapie indiziert.

  • Die chirurgische Resektion erfolgt abhängig von der Lokalisation des Tumors:

    • Ivor Lewis,

    • McKeown,

    • zervikale Resektion oder

    • transhiatal erweiterte Gastrektomie.

  • Eine chirurgische Resektion ist bei Oligometastasierung zurzeit nur im Rahmen von Studien indiziert (RENAISSANCE Trial)

Schlüsselwörter

oberer Gastrointestinaltrakt, Onkologie, Chemotherapie, Radiotherapie, maligne Erkrankung
 

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